Research underlines benefits of lowering blood pressure

Research underlines benefits of lowering blood pressureHigh blood pressure is one of the main causes of heart disease, stroke and premature death in Europe and North America, with about one in three adults afflicted by the condition.

Under current guidelines in Europe, people are considered to have high blood pressure, known medically as hypertension, if their systolic blood pressure, the first of two numbers usually recorded, is above 140mm Hg, or millimetres of mercury.

But a study released in the US last month may force doctors to rethink their approach to the problem.

The National Institutes of Health (USA) study, known as the systolic blood pressure intervention trial (Sprint), followed 9,300 people who were over the age of 50. The trial found that people given medication to lower their blood pressure to 120mm Hg, or 20mm Hg below the previous target, suffered a third fewer heart attacks, heart failure and strokes than control groups. The risk of death declined by a quarter.

The study was so successful that it was ended a year earlier than planned.

The problem is that in order to reach these reduced levels, patients were given a cocktail of three medications. When I asked Paul Thompson, a cardiologist in Hartford, Connecticut, if he has changed his treatment for hypertension as a result, he says “not really”. The main reason, he notes, is the difficulty in getting patients to adhere to such a complicated drug regimen.

“We always have to remember that folks in studies are different from folks in the office,” Dr Thompson says.

When I ask the same question of Rhian Touyz, the director of the Institute of Cardiovascular and Medical Science at the University of Glasgow, she says she is awaiting the full results of the Sprint study, which will be formally presented at a conference in Florida next month, before making any change in recommendations in medications.

However, Professor Touyz does note that lifestyle changes are the first line of defence against hypertension.

One of the biggest contributors to high blood pressure is the large amount of salt in our western diets, not only what we add from the shaker but what is hidden in prepackaged foods and beverages such as breakfast cereals and sports drinks.

It has been known for 50 years that people who eat a low salt diet (under 2g a day) are free from the blood pressure problems common in western industrial countries.

The NHS recommends eating no more than 6g of salt, or 2.4g of sodium a day.

Prof Touyz says that cutting salt intake is only one of several lifestyle changes she recommends. The others include exercising four times a week for 30-40 minutes, cutting alcohol consumption and eating a diet high in fruit and vegetables.

So get your blood pressure checked. For those who have high blood pressure, it would help to increase consumption of kale, spinach, beets and beetroot juice, which are rich in nitrates. The nitrates become nitric oxide in the body, which is a natural dilator of blood vessels, significantly lowering blood pressure.

Source: Financial Times
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